Individual provider Active NPI

Ti Onna Watson

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1417373390
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW131141 Issued in PA
Practice address
320 E Fontanero St Ste 100
Colorado Springs, CO 80907-7535
Phone
(719) 327-6404
NPI assigned
Mar 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW131141 PA Primary

Addresses

Primary practice location

320 E Fontanero St Ste 100
Colorado Springs, CO 80907-7535

Mailing address

320 E Fontanero St Ste 100
Colorado Springs, CO 80907-7535
Phone (719) 327-6404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW131141PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sculpt Station by Z LLC CurrentSince Oct 20, 2024 Accepting new patients

Locations

2601 Cartwright Rd
#D233
Missouri City, TX 77459
Phone (281) 241-9183

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1417373390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E FONTANERO ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077535",
            "telephone_number": "719-327-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E FONTANERO ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077535",
            "telephone_number": "719-327-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TI ONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW131141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.